| Objective:Understand the postpartum contraceptive knowledge,attitude,behavior status and reproductive desire of postpartum women in Binhai New District,explore the influencing factors of postpartum contraceptive cognition level,unexpected pregnancy within one year of postpartum and whether they have reproductive desire,in order to improve the health and family planning of women and children in Binhai New District The quality of postpartum contraceptive services after service integration provides references for exploring the response support measures for medical institutions after the opening of the "comprehensive two children" policy.method:In this study,the epidemiological survey method was adopted to recruit the women who gave birth in tanggu midwifery institutions in Binhai New District,Tianjin from January to December 2018.The included criteria were 18-49 years old,13 community health service centers or 5 midwifery institutions in Tanggu District,Binhai New District,tianjin,who volunteered to participate in the survey and study.Exclusion criteria are refusal to participate in this study;A total of 1300 subjects were recruited.The basic information and relevant data of the study object were extracted through the maternal management subsystem and the decision-making system of Binhai New District in Tianjin.The questionnaire survey was conducted by telephone interview and the informed consent of the subjects was obtained.The main contents of the questionnaire included the cognition level of postpartum contraception,the most desired access to contraceptive knowledge,the main contraceptive methods in the first year after the postpartum,the situation related to unplanned pregnancy in the first year after the postpartum,and the willingness of a pregnant woman to reproduce.1233 valid questionnaires were obtained.The research used SPSS22.0 software to conduct data analysis.The statistical methods mainly include univariate analysis such as frequency distribution,variance analysis,logistic regression analysis,etc,andmultivariate analysis.P < 0.05 is considered as statistically significant.result:1.Cognitive level and influencing factors of postpartum contraception:knowledge score of postpartum contraception was(52.09±14.36),with the lowest score being 10 and the highest score being 100.The lower the educational level,the lower the cognitive level(OR=6.165,95%CI 4.419-9.500,P<0.001),the lower the family per capita monthly income,the lower the cognitive level(OR=1.048,95%CI1.008-1.090,P=0.019),and the lower the cognitive level of postpartum contraception of women whose maternal management organization is level I(OR=1.072,95%CI1.020-1.126,P=0.006).2.Most want access to the contraceptive knowledge: maternal postpartum visit one-to-one mission(34.06%,420/1233)is the most want access to the contraceptive knowledge,maternal followed by tianjin fu apps(26.44%,326/1233)and the building of the management mechanism of maternal mission(22.22%,274/1233),choose by friends and relatives(12.25%,151/1233)and to browse We Chat,weibo and other network information(5.03%,62/1233)for less postpartum contraceptive knowledge of research objects.3.The main methods of contraception in the first year after delivery: 80.62%(994/1233)use condoms,5.19%(64/1233)use safe period contraception,0.41%(5/1233)use lactation contraception,0.16%(2/1233)use compound oral contraceptive and 0.08%(1/1233)use emergency contraceptive.94(7.62%)who chose IUD and other effective contraceptive methods;Seventy-three(5.92%)of postpartum women did not use contraception.The proportion of long-acting reversible contraceptives in the postpartum women in Tanggu district is low.4.Unplanned pregnancy in the first year after delivery and its influencing factors: The incidence of unplanned pregnancy in Tanggu women in Binhai New Area in the first year after delivery was 5.03%(62/1233).Of these,75.81%(47/62)and24.19%(15/62)were unplanned pregnancies within one year after vaginal delivery and 24.19%(15/62)were unplanned pregnancies within one year after cesarean section.Of the pregnancy outcomes,91.94%(57/62)chose induced abortion and8.06%(5/62)continued pregnancy.According to an analysis of factors affecting accidental pregnancy found that low degree of culture of the possibility of accidental pregnancy women(OR = 8.987,95% CI 5.260 to 15.791,P < 0.001),the last before delivery possibility of accidental pregnancy abortion times more women big(OR =3.863,95% CI 1.271 to 9.657,P = 0.008),sex is not appropriate precautions in postpartum women the greater the possibility of accidental pregnancy(OR = 11.760,95% CI 6.304 to 21.654,P<0.001),the possibility of unplanned pregnancy in the first year after delivery was higher in the puerpera under the management of first-level institutions(OR=5.449,95%CI 1.683-33.416,P=0.019).5.Willingness to reproduce and influencing factors of one-born women: In this study,there were 905 one-born women,among which 30.06%(272/905)had the intention to reproduce,63.09%(571/905)had no intention to reproduce,and 6.85%(62/905)had no intention to reproduce.Women who were employees had lower reproductive intentions(OR=1.998,95%CI 1.356～2.934,P<0.001),women with higher education level had lower reproductive intentions(OR=1.851,95%CI1.319～2.590,P<0.001),and women with abnormal postpartum pelvic floor function screening had lower reproductive intentions(OR=1.730,95%CI 1.283～2.346,P<0.001).Conclusion:1.The postpartum contraceptive cognition level of the Tanggu women in Binhai New District is not high.Among them,low education level,low family income,and pregnancy and gestation period management agencies are the first-level institutions.The main influencing factors of postpartum contraceptive cognition level are to strengthen Contraceptive education,improve the quality of family planning services of the first-level pregnancy and delivery management agencies.2.Strengthen the management of "post-natal visit one-to-one education",which is the most desired way for pregnant women to acquire contraceptive knowledge,improve the work process of post-natal visit and the content of propaganda and education,and at the same time give full play to the role of maternal and child APP and the establishment and management organization in prenatal period to effectivelymeet the needs of pregnant women for contraceptive knowledge.3.In the first year after delivery,condoms are the main contraceptive measures for women in Tanggu District,Binhai New Area.The utilization rate of effective and long-acting reversible contraceptive measures is low.4.The low level of postpartum contraceptive awareness,low education level,high frequency of miscarriage,low-efficiency contraceptive measures and the first-class pregnancy management agency are the main influencing factors of unplanned pregnancy in the first year after delivery,and measures should be taken to improve the postpartum pregnancy Contraceptive knowledge level,strengthen contraceptive management of key populations,provide efficient contraceptive methods,improve the awareness and service level of contraceptive propaganda and education of the first-level pregnancy and delivery management agencies,and avoid the occurrence of unintended postpartum pregnancy.5.Professional staff,high degree of education and postpartum pelvic floor functional screening exceptions are the main factors influencing the childbearing willing again,should improve the quality of obstetric delivery,reduce pelvic floor functional damage,strengthening postpartum pelvic floor functional exercise and damage repair,advice from improving occupational stress aspects at the same time,the response national policy,improve the fertility intentions and fertility. |
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